Student Health Insurance for
St Augustine University
Many students and their dependents will require health care at some time during the school year.
You should consider this insurance if you:
currently do not have any health insurance.
have health insurance but it has a deductible and/or co-payments that will leave you paying out-of-pocket expenses.
you have health insurance but it is a PPO, HMO or other insurance plan that has coverage restrictions.
Check your current policy concerning ....
need for medical care away from your local network, such as when you are at school and
the maximum age for coverage
This insurance policy is endorsed by St. Augustine University for the Eligible Students and their Eligible Dependents. Many students and their dependents will require health care at some time during the school year. The University recommends that you take a look at this plan and give it serious consideration.
Brochure
Enrollment Form
50+ Most Frequently Asked Questions
FAQ: Benefits
FAQ: Coverage
FAQ: Cost
FAQ: Enrollment Process
FAQ: How to Use
50+ of the Most Frequently Asked Questions
Benefits of the Plan
Does the plan include deductibles?
Does the plan provide maternity benefits?
Does the plan cover pre-existing conditions?
Does the plan pay for prescriptions?
Does this plan cover health related conditions when I am out of the country?
Does the plan include a Preferred Provider Organization (PPO)?
Coverage Periods
What coverage periods are available? How long of a time period am I covered?
If I elect not to purchase the annual coverage, will I receive notification to re-enroll for continuous coverage?
Can I purchase this plan for one or two semesters?
Can I purchase this plan for one or two semesters? If I purchase the annual coverage and graduate in December 2011 or April 2012, will I be covered through the August 26, 2012 Termination date?
Cost/Payment
How much does it cost?
How do I pay?
How do I know that the company received my premium payment?
Enrollment Process
How do I enroll in the Plan?
How do I pay?
What happens if I do not re-enroll during the 14 day grace period?
Can I enroll after the Effective Date and are the premiums pro-rated?
Will I receive a receipt?
Will I receive an identification card?
Will I receive a copy of the policy?
Can I get a refund?
How do I know that the company has received my payment?
If I elect not to purchase the annual coverage, will I receive notification to re-enroll for continuous coverage?
Using the insurance
How do I get another identification card?
What should I do if the student health center is closed or I am away from school?
Can I choose any physician and hospital?
Does the plan include deductibles?
Does this plan cover health related conditions when I am out of the country?
How do I know if my illness or injury is covered?
Is pre-certification of hospital admissions required?
How do I verify coverage?
How do I file a claim?
How do I check the status of my claim?
Does the plan include a 24/7 Nurse line?
Benefits of the Plan
Does the plan include deductibles?
Yes. The deductible is $50 deductible per Injury or Sickness.
Does the plan provide maternity benefits?
Yes. Maternity is treated as any other illness. Conception must occur after the Insured’s effective date of coverage. Maternity is treated as any other illness. Conception must occur after the Insured’s effective date of coverage.
Does the plan cover pre-existing conditions?
Pre-existing Conditions means any condition which manifested itself in such a manner as would cause an ordinary prudent person to seek medical advice, diagnosis, care or treatment for which medical advice, diagnosis, care or treatment was recommended or received within 6 months immediately prior to the Insured's Effective Date under this policy.
Pre-existing Conditions will apply for the first 6 months, except for individuals who have been continuously insured under the school's student insurance policy for at least 12 consecutive months. Credit will be given for the time the Insured was covered under s similar plan if the previous coverage was continuous to a date not more than 63 days prior to the Insured's Effective Date under this policy.
Does the plan pay for prescriptions?
Yes. Outpatient prescription drugs for a covered injury or sickness.
Injury Only Plan: 90% of usual & customary charges
Injury & Sickness Plan: 90% of usual & customary charges; $300 maximum benefit
Does this plan cover health related conditions when I am out of the country?
Yes. The plan provides coverage 24-hour a day anywhere in the world.
Scholastic Emergency Services: Global Emergency Medical Assistance
If you are a student insured with this insurance plan, you and your insured spouse and minor child(ren) are eligible for Scholastic Emergency Services (SES). The requirements to receive these services are as follows:
International Students, insured spouse and insured minor child(ren): You are eligible to receive SES worldwide, except in your home country.
Domestic Students, insured spouse and insured minor child(ren): You are eligible for SES when 100 miles or more away from your campus address and 100 miles or more away from your permanent home address or while participating in a Study Abroad program.
SES includes Emergency Medical Evacuation and Return of Mortal Remains that meet the US State Department requirements. The Emergency Medical Evacuation services are not meant to be used in lieu of or replace local emergency services such as an ambulance requested through emergency 911 telephone assistance. All SES services must be arranged and provided by SES, Inc., any services not arranged by SES, Inc. will not be considered for payment.
Please visit your school's insurance coverage page at http://firststudent.com/schools/UniversityofStAugustine.htm for the SES Global Emergency Assistance Services brochure which includes service descriptions and program exclusions and limitations.
To access services please call:
(877) 488-9833 Toll-free within the United States
(609) 452-8570 Collect outside the United States
Does the plan include a Preferred Provider Organization (PPO)?
No. The Insured is able to choose any physician and hospital.
Coverage Periods
What coverage periods are available? How long of a time period am I covered?
The plan may be purchased for the following coverage periods.
Coverage Period |
|
Annual |
08-27-11 to 08-26-12 |
Fall |
08-27-11 to 12-31-11 |
Spring |
01-01-12 to 04-25-12 |
Summer |
04-25-12 to 08-26-12 |
Click for brochure click for enrollment form
These are pdf files which have been created by Adobe. All downloadable information on this site is in the Adobe PDF File format. To view this file you will need to have the Adobe Acrobat Reader Plug-in installed on your computer. Get the free Adobe Acrobat Reader Plug-in here: www.adobe.com/products/acrobat/readstep.htm
No. It is the Insured’s responsibility for timely payments during the 14 day grace period to re-enroll and maintain continuous coverage.
Can I purchase this plan for one or two semesters?
Yes. Please see for coverage periods.
Yes. Coverage will terminate on the last day of the period r premium has been paid (August 26, 2012).
Cost/Payment
The premiums depend upon the length of coverage and the number of Insureds. The premiums are affordable and your acceptance is guaranteed.
08-27-11 |
08-27-11 |
01-01-12 |
04-25-12 |
|
Basic Injury Benefit |
||||
Student Only |
$ 348 |
$123 |
$112 |
$120 |
Basic Injury & Sickness Benefit |
||||
Student Only |
$ 699 |
$247 |
$225 |
$241 |
Spouse |
$2322 |
$820 |
$748 |
$800 |
Each Child |
$1015 |
$358 |
$327 |
$350 |
Make check or money order payable to United Health Care/Student Resources in US dollars. Mail the enrollment card along with premium payment to:
First Risk Advisors, Inc.
67 W Court Street
Doylestown, PA 18901
Only the above office is authorized to accept and processes your completed enrollment form; do not send it elsewhere. Your cancelled check or credit card billing is your only receipt and notification of coverage. It is the student’s responsibility for timely renewal payment whether or not a renewal notice is received.
How do I know that the company received my premium payment?
Receipt of premium can be verified by contacting:
First Student by:
Toll-free: 800-505-4160
Website: http://firststudent.com/schools/UniversityofStAugustine/customer_services.htm
Your canceled check is your receipt and proof of coverage.
Complete the enrollment form and mail or enroll on-line for each coverage period. Coverage may be purchased prior to the effective date with coverage beginning on the effective date of coverage purchased.
On-line enrollment at http://firststudent.com/schools/UniversityofStAugustine/enrollment.htm
Click forbrochureforenrollment form
These are pdf files which have been created by Adobe. All downloadable information on this site is in the Adobe PDF File format. To view this file you will need to have the Adobe Acrobat Reader Plug-in installed on your computer. Get the free Adobe Acrobat Reader Plug-in here:www.adobe.com/products/acrobat/readstep.htm
The enrollment forms may be obtained from the Registrar's Office or by contacting Al at HBCstudent
Make check or money order payable to United Health Care/Student Resources in US dollars. Mail the enrollment card along with premium payment to:
First Risk Advisors, Inc.
67 W Court Street
Doylestown, PA 18901
Only the above office is authorized to accept and processes your completed enrollment form; do not send it elsewhere. Your cancelled check or credit card billing is your only receipt and notification of coverage. It is the student’s responsibility for timely renewal payment whether or not a renewal notice is received.
What happens if I do not re-enroll during the 14 day grace period?
If the premium is not paid within the 14 day grace period, coverage will lapse at the end of the coverage period. If premium is subsequently paid, a new effective date of coverage will be established.
Can I enroll after the effective date and are the premiums pro-rated?
Yes. You can purchase insurance coverage at any time. However, your coverage may vary depending in the timing of your enrollment:
If you were covered by the 2010-2011 student health insurance plan and you enroll in the 14 day grace period, you will qualify for continuous coverage. This means that the pre-existing condition exclusion will not apply for any conditions that were covered claims in the previous school year.
If you were covered by the 2010-2011 student health insurance plan and you do not enroll within the 14 day grace period, the pre-existing condition exclusion will apply for claims that are submitted for payment.
If you are a new student or enrolling due to an involuntary loss of coverage from another source, you may enroll at anytime, and the pre-existing condition exclusion will apply.
Premiums are not pro-rated. Please note the premiums are charged by coverage period. If you enroll after a coverage period has begun, you must still pay the full premium. There is no provision in the policy for "pro-rating" of premiums.
No. Your canceled check is your receipt and proof of coverage.
Will I receive an identification card?
Yes. If you need to access services before you receive your ID card, your provider can contact:
First Student by:
Toll-free: 800-505-4160
Website: http://firststudent.com/schools/UniversityofStAugustine/customer_services.htm
Will I receive a copy of the policy?
No. The Master Policy is on file at the University of St. Augustine-Registrar's office. No individual policies will be issued. In the event of a claim dispute, the Master Policy will prevail. Please retain the brochure as it outlines the provisions of coverage.
No. The only situations that allow for a refund is if the Insured enters or becomes active in the armed services of any country.
How do I know that the company received my premium payment?
Receipt of premium can be verified by contacting:
First Student by:
Toll-free: 800-505-4160
Website: http://firststudent.com/schools/UniversityofStAugustine/customer_services.htm
Your canceled check is your receipt and proof of coverage.
If I elect not to purchase the annual coverage, will I receive notification to re-enroll for continuous coverage?
No. It is the Insured’s responsibility for timely payments during the 14 day grace period to re-enroll and maintain continuous coverage.
How do I get another identification card?
An identification card may be obtained by contacting:
First Student by:
Toll-free: 800-505-4160
Website: http://firststudent.com/schools/UniversityofStAugustine/customer_services.htm
What should I do if the student health center is closed or I am away from school?
You are covered anywhere in the word, 24-hours a day. You should consult a medical professional and follow his or her advice.
Can I choose any physician and hospital?
Yes. You can choose any physician or hospital.
Does the plan include deductibles?
Yes. The deductible is $50 deductible per Injury or Sickness.
Does this plan cover health related conditions when I am out of the country?
Yes. The plan provides coverage 24-hour a day anywhere in the world.
Scholastic Emergency Services: Global Emergency Medical Assistance
If you are a student insured with this insurance plan, you and your insured spouse and minor child(ren) are eligible for Scholastic Emergency Services (SES). The requirements to receive these services are as follows:
International Students, insured spouse and insured minor child(ren): You are eligible to receive SES worldwide, except in your home country.
Domestic Students, insured spouse and insured minor child(ren): You are eligible for SES when 100 miles or more away from your campus address and 100 miles or more away from your permanent home address or while participating in a Study Abroad program.
SES includes Emergency Medical Evacuation and Return of Mortal Remains that meet the US State Department requirements. The Emergency Medical Evacuation services are not meant to be used in lieu of or replace local emergency services such as an ambulance requested through emergency 911 telephone assistance. All SES services must be arranged and provided by SES, Inc., any services not arranged by SES, Inc. will not be considered for payment.
Please visit your school's insurance coverage page at www.firststudent.com for the SES Global Emergency Assistance Services brochure which includes service descriptions and program exclusions and limitations.
To access services please call:
(877) 488-9833 Toll-free within the United States
(609) 452-8570 Collect outside the United States
How do I know if my illness or injury is covered?
Refer to the Medical Benefits Schedule in your brochure to determine covered and Covered Service. You should also review the Exclusions section of the brochure and the definitions of Pre-existing conditions and Elective Surgery & Elective Treatment to understand what conditions are not covered.
If you have any questions, please contact:
First Student by:
Toll-free: 800-505-4160
Website: http://firststudent.com/schools/UniversityofStAugustine/customer_services.htm
Is pre-certification of hospital admissions required?
Yes. UMR Care Management should be notified for All Hospital Confinements prior to admission.
1. Pre-Notification of Medical non-Emergency Hospitalization: The patient, Physician or Hospital should telephone 1-877-295-0720 at least five working days prior to the planned admission.
2. Notification of Medical Emergency Admission: The patient, patient's representative, Physician or Hospital should telephone 1-877-295-0720 within two working days of the admission to provide notification of nay admission due to Medical Emergency.
UMR Care Management is open for Pre-Admission Notification calls from 8:00 am to 6:00 pm CST. Monday through Friday. Calls may be left on the Customer Service Department's voice mail after hours by calling 1-877-295-0720.
Important: Failure to follow the notification procedures will not affect benefits otherwise payable under the policy; however, pre-notification is not a guarantee that benefits will be paid.
Verification of coverage may be obtained by contacting
First Student by:
Toll-free: 800-505-4160
Website: http://firststudent.com/schools/UniversityofStAugustine/customer_services.htm
In the event of Injury or Sickness, student should:
1. Report to the Student Health Service or Infirmary for treatment, or when not in school, to their Physician or Hospital.
2. Mail to the address below all medical and hospital bills along with the patient's name and insured student's name, address, social security number and the name of the university under which the student is insured.
A company claim form is not required for filing a claim.
3. File claim within 30 days of Injury or first treatment for a Sickness. Bills should be received by
the company within 90 days of service. Bill submitted after one year will not be considered
for payment except in the absence of legal capacity.
Direct all Claim and/or Customer Service Inquiries to:
First Student
PO Box 809025
Dallas, TX 75380-9025
Telephone: 800-505-4160
Websites:
http://firststudent.com/schools/UniversityofStAugustine/file_a_medical_claim.htm
http://firststudent.com/schools/UniversityofStAugustine/customer_services.htm
How do I check the status of my claim?
Status of the claim may be obtained by contacting:
First Student by:
Toll-free: 800-505-4160
Website: http://firststudent.com/schools/UniversityofStAugustine/check_claim_status.htm
Does the plan include a 24/7 Nurse line?
Insured Students have access to nurse advice, health information, and counseling support 24 hours a day, 7 days a week by dialing the number indicated on the permanent ID card. Collegiate Assistance Program is staffed by Registered Nurses and Licensed Clinicians who can help students determine if they need to seek medical care, need legal/financial advice or may need to talk to someone about everyday issues that can be overwhelming.
Telephone: 1-800-525-4160
Website: http://firststudent.com/schools/UniversityofStAugustine/call_a_nurse.htm
The Master Policy on file at the University contains all of the provisions, limitations, exclusions and qualification of your insurance benefits, some of which may not be included in this Frequently Asked Questions. If any discrepancy exists between this Frequently Asked Questions and the Master Policy, the Master Policy will govern and control the payments of benefits. Master Policy #2011-200422-91
Need additional assistance?
call Al at 1.800.463.2317 or email Al